2. Objectives
Define hepatitis.
Types of hepatitis.
Pathophysiology of hepatitis.
Epidemiology of disease.
Prevalence of hepatitis in Pakistan.
Mode of transmission.
Clinical features of hepatitis.
Complications of hepatitis.
Diagnosis of hepatitis.
Control and treatment of hepatitis.
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3. Definition
Viral hepatitis is a systematic disorder that primarily
involves the liver causing hepatocellular
inflammation and is characterized by fever,
gastrointestinal manifestation and jaundice.
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5. Types of hepatitis
There are several types of hepatitis which are given as follows:
•Hepatitis A virus.
•Hepatitis B virus.
•Hepatitis C virus.
•Hepatitis D virus.
•Hepatitis E virus.
•Hepatitis G virus.
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6. TYPES OF HEPATITIS.
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Virus Route of spread Diagnostic test Carrier state Incubation period
HAV Feco oral Anti-HAV IgM. NO 15-19 Days
HBV Parenteral HBsAG , anti
HBc IgM.
YES 60-180 days
HCV Parenteral Anti-HCV,PCR-
RNA test.
YES 14-160 days
HDV Parenteral Anti- HDV. YES 20-42 days
HEV Feco oral Anti-HEV. NO 21-63 days
HGV Parenteral
9. Epidemiology
A. Distribution:
1-By time: No seasonal fluctuations.
2-By place: Common in areas where there is:
•Poor personal hygiene
•Common homosexuality
•Traditional practices like tattoo, ear piercing.
3-By person:
Age: in developed countries between age 20-40 years.
In developing countries it is common in early childhood.
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10. Prevalence in Pakistan
In Pakistan almost 12 million people are suffering from hepatitis B or
C. Each year brings about 150 000 new cases. The majority of people
catch this infection in health care settings without being aware of it.
According to statistics compiled by the World Health Organization
(WHO), 4 to 5% of the Pakistani population is suffering
from hepatitis C, resulting in one of the highest infection rates in the
world.
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11. Reservoir:
Man in carrier state ( presence of HBsAg for more than 9months).
High risk groups:
•Recipient of blood transfusions.
•Health care personals.
•I/V drug abusers.
•Infant of HBV mother.
•Immuno compromised patients.
•Poor hygiene.
•Poor sanitation.
•Fecal contamination.
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12. Mode of transmission:
Modes of transmission are:
1) Fecal-Oral route:
Water borne , food borne.
2) Direct transmission.
3) Parenteral route:
Transmit through blood and blood products transfusion or skin contamination by
needles , syringes etc.
4) trans placental transmission (HBV):
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14. Complications
complications of viral hepatitis may include the following:
•Acute or sub acute hepatic necrosis.
•Chronic hepatitis.
•Cirrhosis.
•Hepatic failure.
•Hepatocellular carcinoma (HCC) in patients with HBV or HCV infection
•Post viral encephalitis.
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15. Prevention and control :
• Improved hygiene
•Vaccination
•Blood screening
•Sterile needles and syringes
•Safe sex practice
•Properly cook food ( avoid uncooked meat)
•Proper sanitation
•Control of flies
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17. Treatment :
Symptomatic and therapies are given to the patient.
•Promote rest
•Small , frequent feedings of a high calorie , low fat diet ,
•Proteins are restricted.
•I/V fluids and electrolyte replacement
•Interferon ( immunoglobulin) may be given in Hepatitis B , C and E virus.
•Liver transplant
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19. Vaccination :
Vaccines are available for
Hepatitis A
( Havrix and Vaqta )deltoid muscle of arm.
Hepatitis B
( Engerix-B , Recombivax )
No vaccine available for Hepatitis C.
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